|
CEMENTRALIZER 10.0
|
Facility
|
OP
|
$2,092.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.96 |
| Max. Negotiated Rate |
$2,008.32 |
| Rate for Payer: Aetna Commercial |
$1,610.84
|
| Rate for Payer: Anthem Medicaid |
$719.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,631.76
|
| Rate for Payer: Cash Price |
$1,046.00
|
| Rate for Payer: Cigna Commercial |
$1,736.36
|
| Rate for Payer: First Health Commercial |
$1,987.40
|
| Rate for Payer: Humana Commercial |
$1,778.20
|
| Rate for Payer: Humana KY Medicaid |
$719.44
|
| Rate for Payer: Kentucky WC Medicaid |
$726.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,715.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,543.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$627.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$733.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,840.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,569.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$418.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$271.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$648.52
|
| Rate for Payer: PHCS Commercial |
$2,008.32
|
| Rate for Payer: United Healthcare All Payer |
$1,840.96
|
|
|
CEMENTRALIZER 10.0
|
Facility
|
IP
|
$2,092.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.96 |
| Max. Negotiated Rate |
$2,008.32 |
| Rate for Payer: Aetna Commercial |
$1,610.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,631.76
|
| Rate for Payer: Cash Price |
$1,046.00
|
| Rate for Payer: Cigna Commercial |
$1,736.36
|
| Rate for Payer: First Health Commercial |
$1,987.40
|
| Rate for Payer: Humana Commercial |
$1,778.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,715.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,543.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$627.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,840.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,569.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$418.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$271.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$648.52
|
| Rate for Payer: PHCS Commercial |
$2,008.32
|
| Rate for Payer: United Healthcare All Payer |
$1,840.96
|
|
|
CEMENTRALIZER 10.5
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 10.5
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 11.0
|
Facility
|
IP
|
$2,004.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$260.58 |
| Max. Negotiated Rate |
$1,924.32 |
| Rate for Payer: Aetna Commercial |
$1,543.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,563.51
|
| Rate for Payer: Cash Price |
$1,002.25
|
| Rate for Payer: Cigna Commercial |
$1,663.74
|
| Rate for Payer: First Health Commercial |
$1,904.28
|
| Rate for Payer: Humana Commercial |
$1,703.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,643.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,479.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$601.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,763.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,503.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.40
|
| Rate for Payer: PHCS Commercial |
$1,924.32
|
| Rate for Payer: United Healthcare All Payer |
$1,763.96
|
|
|
CEMENTRALIZER 11.0
|
Facility
|
OP
|
$2,004.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$260.58 |
| Max. Negotiated Rate |
$1,924.32 |
| Rate for Payer: Aetna Commercial |
$1,543.46
|
| Rate for Payer: Anthem Medicaid |
$689.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,563.51
|
| Rate for Payer: Cash Price |
$1,002.25
|
| Rate for Payer: Cigna Commercial |
$1,663.74
|
| Rate for Payer: First Health Commercial |
$1,904.28
|
| Rate for Payer: Humana Commercial |
$1,703.82
|
| Rate for Payer: Humana KY Medicaid |
$689.35
|
| Rate for Payer: Kentucky WC Medicaid |
$696.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,643.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,479.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$601.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$703.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,763.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,503.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.40
|
| Rate for Payer: PHCS Commercial |
$1,924.32
|
| Rate for Payer: United Healthcare All Payer |
$1,763.96
|
|
|
CEMENTRALIZER 11.5
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 11.5
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 12.0
|
Facility
|
OP
|
$2,004.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$260.58 |
| Max. Negotiated Rate |
$1,924.32 |
| Rate for Payer: Aetna Commercial |
$1,543.46
|
| Rate for Payer: Anthem Medicaid |
$689.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,563.51
|
| Rate for Payer: Cash Price |
$1,002.25
|
| Rate for Payer: Cigna Commercial |
$1,663.74
|
| Rate for Payer: First Health Commercial |
$1,904.28
|
| Rate for Payer: Humana Commercial |
$1,703.82
|
| Rate for Payer: Humana KY Medicaid |
$689.35
|
| Rate for Payer: Kentucky WC Medicaid |
$696.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,643.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,479.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$601.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$703.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,763.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,503.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.40
|
| Rate for Payer: PHCS Commercial |
$1,924.32
|
| Rate for Payer: United Healthcare All Payer |
$1,763.96
|
|
|
CEMENTRALIZER 12.0
|
Facility
|
IP
|
$2,004.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$260.58 |
| Max. Negotiated Rate |
$1,924.32 |
| Rate for Payer: Aetna Commercial |
$1,543.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,563.51
|
| Rate for Payer: Cash Price |
$1,002.25
|
| Rate for Payer: Cigna Commercial |
$1,663.74
|
| Rate for Payer: First Health Commercial |
$1,904.28
|
| Rate for Payer: Humana Commercial |
$1,703.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,643.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,479.32
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$601.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,763.96
|
| Rate for Payer: Ohio Health Group HMO |
$1,503.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.40
|
| Rate for Payer: PHCS Commercial |
$1,924.32
|
| Rate for Payer: United Healthcare All Payer |
$1,763.96
|
|
|
CEMENTRALIZER 12.5
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 12.5
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 13.0
|
Facility
|
OP
|
$2,029.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.77 |
| Max. Negotiated Rate |
$1,947.84 |
| Rate for Payer: Aetna Commercial |
$1,562.33
|
| Rate for Payer: Anthem Medicaid |
$697.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,582.62
|
| Rate for Payer: Cash Price |
$1,014.50
|
| Rate for Payer: Cigna Commercial |
$1,684.07
|
| Rate for Payer: First Health Commercial |
$1,927.55
|
| Rate for Payer: Humana Commercial |
$1,724.65
|
| Rate for Payer: Humana KY Medicaid |
$697.77
|
| Rate for Payer: Kentucky WC Medicaid |
$704.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,663.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,497.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$608.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$711.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,785.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,521.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$405.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$263.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$628.99
|
| Rate for Payer: PHCS Commercial |
$1,947.84
|
| Rate for Payer: United Healthcare All Payer |
$1,785.52
|
|
|
CEMENTRALIZER 13.0
|
Facility
|
IP
|
$2,029.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.77 |
| Max. Negotiated Rate |
$1,947.84 |
| Rate for Payer: Aetna Commercial |
$1,562.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,582.62
|
| Rate for Payer: Cash Price |
$1,014.50
|
| Rate for Payer: Cigna Commercial |
$1,684.07
|
| Rate for Payer: First Health Commercial |
$1,927.55
|
| Rate for Payer: Humana Commercial |
$1,724.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,663.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,497.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$608.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,785.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,521.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$405.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$263.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$628.99
|
| Rate for Payer: PHCS Commercial |
$1,947.84
|
| Rate for Payer: United Healthcare All Payer |
$1,785.52
|
|
|
CEMENTRALIZER 13.5
|
Facility
|
IP
|
$1,721.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$223.73 |
| Max. Negotiated Rate |
$1,652.16 |
| Rate for Payer: Aetna Commercial |
$1,325.17
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,342.38
|
| Rate for Payer: Cash Price |
$860.50
|
| Rate for Payer: Cigna Commercial |
$1,428.43
|
| Rate for Payer: First Health Commercial |
$1,634.95
|
| Rate for Payer: Humana Commercial |
$1,462.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,411.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,270.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$516.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,514.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,290.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$344.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$223.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$533.51
|
| Rate for Payer: PHCS Commercial |
$1,652.16
|
| Rate for Payer: United Healthcare All Payer |
$1,514.48
|
|
|
CEMENTRALIZER 13.5
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$223.73 |
| Max. Negotiated Rate |
$1,652.16 |
| Rate for Payer: Aetna Commercial |
$1,325.17
|
| Rate for Payer: Anthem Medicaid |
$591.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,342.38
|
| Rate for Payer: Cash Price |
$860.50
|
| Rate for Payer: Cigna Commercial |
$1,428.43
|
| Rate for Payer: First Health Commercial |
$1,634.95
|
| Rate for Payer: Humana Commercial |
$1,462.85
|
| Rate for Payer: Humana KY Medicaid |
$591.85
|
| Rate for Payer: Kentucky WC Medicaid |
$597.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,411.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,270.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$516.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$603.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,514.48
|
| Rate for Payer: Ohio Health Group HMO |
$1,290.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$344.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$223.73
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$533.51
|
| Rate for Payer: PHCS Commercial |
$1,652.16
|
| Rate for Payer: United Healthcare All Payer |
$1,514.48
|
|
|
CEMENTRALIZER 14.0
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 14.0
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 14.5
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 14.5
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 15.0
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 15.0
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 15.5
|
Facility
|
IP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 15.5
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
|
CEMENTRALIZER 16.0
|
Facility
|
OP
|
$1,987.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.31 |
| Max. Negotiated Rate |
$1,907.52 |
| Rate for Payer: Aetna Commercial |
$1,529.99
|
| Rate for Payer: Anthem Medicaid |
$683.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,549.86
|
| Rate for Payer: Cash Price |
$993.50
|
| Rate for Payer: Cigna Commercial |
$1,649.21
|
| Rate for Payer: First Health Commercial |
$1,887.65
|
| Rate for Payer: Humana Commercial |
$1,688.95
|
| Rate for Payer: Humana KY Medicaid |
$683.33
|
| Rate for Payer: Kentucky WC Medicaid |
$690.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,629.34
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,466.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$697.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,748.56
|
| Rate for Payer: Ohio Health Group HMO |
$1,490.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$397.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$258.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$615.97
|
| Rate for Payer: PHCS Commercial |
$1,907.52
|
| Rate for Payer: United Healthcare All Payer |
$1,748.56
|
|
